Registered Nurses’ Association of Ontario,

Best series (Daily Newspaper)

Heather Rivers, Woodstock Sentinel-Review

“Big barriers to mental health”

It all started with an overheard snippet of conversation. At first it seemed like an everyday conversation by a woman bantering to a friend about the difficulty she encountered accessing mental health services in this region.

After casually looking into her complaint, it soon became apparent that patients in our area were facing big barriers to getting help for mental health issues. In fact, they were waiting 240 more days for access to mental health case management than those in other neighbouring communities. It was a significant story to be sure but little did I know it would become the inspiration for a number of articles about the issue. This submission was chosen from several stories written in 2014 about the major barriers residents have faced in obtaining access to mental services both today and historically in Oxford County.

In the second story, a young mother of two shares her horror story of how, due to a lack of psychiatrists and a confusing system, she ended up being forced to voluntarily admit herself to a psychiatric ward in order to stabilize her mental health.

The third article examines the gritty issue of court-ordered intervention and the heart-wrenching story of a local mother who claimsa lack of early intervention by the mental health system for her child may have ultimately led to his death.

With no prior knowledge or application by myself, in the spring of 2014 I was contacted by Ontario branch of Canadian Mental Health Association who informed me that because of the numerous stories I wrote dispelling stigma associated with mental illness they were presenting me with the annual media award for outstanding contributions to coverage of mental health and addictions issues at the local level.

Thank you for considering my submission,

Heather Rivers, Bruce Urquhart,

Reporter Managing editor

“Big barriers to mental health”

0 / 39 -Thursday, January 23, 2014

Wait times out of whack
Edition:Final
Source:HEATHER RIVERS, SENTINEL-REVIEW
Section:NewsPage:A1

Patients in Oxford County are waiting up to 240 more days for mental health counselling, treatment and case management than those living in neighbouring communities.
According to statistics supplied by ConnexOntario, which maintains an up-to-date database of detailed drug, alcohol, problem gambling, and mental health service information, Oxford patients are waiting up to 228 days for mental health counselling and treatment and 240 days for case management.
In Elgin County, wait times for counselling and treatment are virtually hours, while in Perth, patients wait 10 days.
For case management, the wait time in Elgin is 13 days and seven days in Perth.
MikeMcMahon, executive director of the Oxford branch of the Canadian Mental Health Association, said it's difficult to make comparison between the three counties.
"We're not happy people have to wait for case management services," he said, "but we do know the Local Health Integration Networks have varying degrees of reporting on wait times. It's not black and white."
McMahonalso added that about 200 clients of the Tillsonburg Psychiatric Clinic were discharged when the clinic closed in 2013, which added heavily to local caseloads. He said patients in crisis are treated immediately by a specialized crisis team and even patients on wait lists receive service known as brief treatment.
"If they're on a wait list, we're still servicing people," he said.
Jayne Menard, vice-president of patient care at Woodstock Hospital, where counselling and treatment for mental illness is provided, explained part of the problem is a shortage of doctors.
"There is a Canadawide shortage of psychiatrists," she explained.
The hospital only has two full-time psychiatrists -Dr. Lakshman Fernando and Dr. Shabbir Amanullah -and only a few consulting psychiatrists for specialty populations, such as those suffering eating disorders or child psychiatry.
"We could use further manpower for services we provide in that area," she said. "In specialty areas, there is a real need."
Perth County, in comparison, has nine psychiatrists to treat the mentally ill population.
"They have a concerted strategy in Huron/Perth to attract psychiatrists to the area,"McMahonsaid.
Michelle Worsfold, director of mental health services at the hospital, said the community recently lost "a well-liked and respected" psychiatrist.
Dr. Pramil Tahlan died last October at the age of 64.
"It had a huge impact on our wait list," she said. "She treated a lot of patients in the community -she has a huge roster."
For patients who arrive at the hospital's emergency room needing a bed for a serious mental health issue, there is virtually no wait.
"They can get in within a number of hours. It has not been an issue here, with our increased capacity, but that's not to say it won't be an issue in the future," Menard said.
While wait times for mental health treatment and counselling are considered high, substance abuse programs -which once were subject to a three-month wait -are now the lowest of all three counties.
In Oxford there is an average wait of 12 days for community treatment for addiction, in Elgin it's 57 days and, in Perth County, it is 14.

2 / 13 -Wednesday, May 7, 2014

Navigating a broken system
Edition:Final
Source:HEATHER RIVERS, SENTINEL-REVIEW
Section:NewsPage:A1

Today,NicoleLalondeis grateful she has access to a psychiatrist, a counsellor and group therapy sessions at Woodstock Hospital.
"There are a lot of positives that came from this," she said.
But what the 39-year-old Woodstock woman had to endure to get those services--including a voluntarily stay in the psychiatric ward-- is disturbing and happening far too often, local experts say.
"I'm really not surprised, unfortunately," said Laura Earle, executive director of Oxford Self-Help Network of Lalonde's story. "The system is confusing. There are different places to go and how do you qualify? There are a lot of barriers.
"It's a lack of services and a huge lack of psychiatrists."
Lalonde, who had to navigate through the mental health system to get help for post-traumatic stress and bipolar disorder, said the system simply isn't working.
"Mental health is being left until it gets to a crisis status," Lalonde said. "To get help, people have to be put in hospital by a family member or go into hospital because they threaten to commit suicide or have had a complete breakdown."
Mike McMahon, executive director of the Oxford Canadian Mental Health Association, explains the lack of psychiatrists is causing major delays in access to case management.
"Access to psychiatry is the biggest issue the Oxford County Mental Health and Addictions Network faces. It has remained the focus of the network's work plan," McMahon said. "In my opinion, the question is why can't we recruit more psychiatrists? Woodstock Hospital's success in recruiting is imperative for the community."
At age 17, Lalonde began experiencing panic attacks and was later diagnosed with obsessive-compulsive disorder. Three years ago, Lalonde was also diagnosed with bipolar disorder by a local psychiatrist.
Unable to see the psychiatrist as a followup due to long wait times, her family doctor would prescribe her medicine based on the advice the psychiatrist sent through letters.
Lalonde also put herself on a wait list for the Oxford branch of the Canadian Mental Health Association (CMHA), which currently has a 240-day wait time for case management.
But because CMHA was unable to get confirmation of her diagnosis from her psychiatrist, she was never able to use those services. Meanwhile, Lalonde, the mother of two young children, was juggling more than anyone should ever be expected to endure.
Her young son had a life-threatening illness that required a liver transplant and then, after becoming extremely ill, required a second. It was a rollercoaster ride for the young family.
"Taking care of my child was my top priority," she said. "I gave up and put (my mental health) on the backburner, and just waited to get a call."
After the crisis was over, and her son received a second liver transplant, Lalonde said she expected her moods to improve.
"I expected to feel really happy. I just didn't," she said. "I'd be in the middle of a grocery store and have a panic attack."
After years of worry over her son's health, Lalonde had developed post-traumatic stress disorder, a mental illness that involves exposure to trauma such as death, threat of death or serious injury.
"I felt like I was having a complete nervous breakdown," she said.
Desperate to feel better, she went to see a costly therapist, who advised her to immediately go to the hospital.
"My medication wasn't working," she said. "She saw I couldn't cope on my own anymore. I was in crisis."
At the hospital, the crisis team was extremely helpful but informed Lalonde she could either admit herself voluntarily or wait three months to see a psychiatrist.
Lalonde knew she couldn't wait any longer and voluntarily checked herself in.
"I knew I had to do it, I had to," she said.
It was an experience that Lalonde will never forget or want to repeat, but, she said, was well worth it.
"I started to feel better," she said.
To add to the issue, l she received a letter with a followup date with a psychiatrist after she was released from hospital. Her next appointment would not be until Nov. 22, 2014. Eventually, after approaching an intake worker, her appointment was moved up.
"I had to call myself. I had to complain. If I wasn't a person who didn't fight for themselves, I would be eight months waiting," she said.
But now, Lalonde explains, she has a psychiatrist, an individual counsellor and outpatient services that include group sessions.
"But," she said. "I had to go through all that to get it."
Earle, who also has bipolar disorder, explained that everyone who works for the Oxford Self-Help Network has a mental illness.
"We've been there, (so) we know what it feels like," she said.
The organization -which has no waiting lists, no fees and no appointments -offers peer support.
"I've often thought we need someone to guide people through the system. Someone who isn't going to give you therapy but gives you direction," Earle said. "If you are not well, it's hard to find what you need. A lot of times families don't know where to go."
She urged people to contact the CMHA to put their name on the waiting list if they have mental health issues.
"If you need to talk to someone, there is the crisis line," she said.

3 / 77 -Tuesday, July 8, 2014

A tragic end to a mother's struggle
Edition:Final
Source:HEATHER RIVERS, SENTINEL-REVIEW
Section:NewsPage:A1

Marion Waugh lives in a world of what ifs.
Every day, the Woodstock grandmother asks herself what if her parental rights had included getting her teenage son Michael the help he needed for mental health and addiction issues in 1995?
Or what if the court system demanded he get help at a young age before he ended up in jail and rehab multiple times?
"No one can tell me if he didn't have that choice (to not seek treatment) that his life and ultimately his death could have been prevented," she said. "That's what I can never accept."
Back in the mid-1990s Waugh, now 56, was in the news dozens of times pleading with the court system to get tough with her young offender son who refused treatment for mental health and addictions issues.
"What I worked for back then was my right as a parent to help my child," she said. "I found I was fighting the system continuously."
She circulated petitions, made impassioned pleas to politicians and wrote countless letters -anything to get her son the help she felt he needed.
"I tried so hard to help him ... It's like they're in a lake and they are drowning," she said. "You want to jump off the dock and save them, but every single hand of democracy is holding you back."
Michael, who had begun exhibiting violent tendencies and criminal behaviour at the age of 13, refused to get treatment, a right young people in the court system still have. In 1996 she told the Sentinel-Review her son "needs help but no one will let us get it for him."
"I am relieved that nothing happened this time, but I'm afraid if this carries on he'll be 25 years old and in Kingston Penitentiary," she was quoted as saying.
After years of not speaking to the press and five years after her son's death, Waugh says it is time to tell Michael's story.
"I just felt it was time. Nothing has changed," she said. "It's too late for Michael and me, but there are so many still out there."
Michael was born in Orangeville in 1981. Waugh's then-husband worked in road construction and the family moved around a lot. By the time Michael was in Grade 3, the family was living outside of Embro.
She described her son, growing up, as "fearless and extremely athletic." On the surface, he exhibited bravado and wit, but underneath he was insecure and vulnerable.
"He started to get disruptive in class, started having nightmares and not wanting to go to school, which was unusual for him," she said. "He was regarded as difficult."
At age 13, he was suspended from school for fighting and smoking. He had also become hostile at home. They suspected he was sniffing Varsol and diesel fuel.
Attempts to get counselling proved unsuccessful, as he would bolt from sessions his mother had arranged.
"He was in a rage, out of control," she said In March 1995, Michael stole the family truck and was subsequently charged.
He was arrested again in October for stealing a bike, and then arrested a second time that same day for stealing a car. He threatened suicide several times and often ran away from home.
It was at that time the London Family Court Clinic recommended he be placed in a treatment facility for a year, but Michael refused treatment and went into open custody. Later, when Michael began co-operating with a psychiatrist, Waugh, who had recently split with her husband, learned her son had ADHD and oppositional defiant disorder, and had been prescribed Ritalin. The problem, Waugh said, was the detention centre wouldn't allow the drug.
In jail, Michael was back in trouble, facing an assault charge. He also been charged with uttering seven death threats, and successfully escaped jail for a week. When he was released, the bad behaviour persisted, and he was arrested for breaking and entering, possession of narcotics and a probation breach.
In 1997, he was involved in a high-speed chase, and arrested for possessing a stolen vehicle, finding himself back in jail until charges were dropped.
Living with his mother and stepfather, Michael made a huge effort to change, Waugh said.
"He would always try so hard to be good, be normal, then it would all go to hell and he never knew why," she said. "It was like a bomb went off in his head."
By 1999, Michael had become an adult, but continued to use drugs and alcohol while working in a series of odd jobs "here and there."
He became involved in a long-term relationship, and had two children.
He eventually ended up in at a mental-health facility, where he got some -but not enough -counselling.
Back in society after his release, Michael became hooked on methamphetamines and crack. In 2006, while working for a roofing company, he decided to go into rehab.
"It was fantastic," said Waugh, who would join him on weekends for the family program. "He was clean, sober and drug-free. My world lit up."
Eventually things were so good he started his own small roofing business. But in October 2008, Michael fell off a roof and was prescribed Percocet for significant pain from his injuries
"I begged him to flush them," she said. "That was the start of a slow slide down."
Eventually, he ended up in hospital after he exhibited signs of paranoia, and began taking medicine for bipolar disorder.
Despite being stabilized, he went back to drugs once he left the hospital, despite knowing the combination of crack and antipsychotic drugs could prove disastrous.
"He knew he was playing Russian roulette," his mother said. "We both knew he wasn't going to live; we just didn't know when."
Often late at night, Michael would call her while sitting outside of detox waiting for a spot in the facility.
Sometimes they would talk; sometimes they wouldn't.
"He just wanted me to be there," she said.
In September 2009, Michael had a massive heart attack that left him without oxygen for 20 minutes. At a London hospital, they put him into a drug-induced coma before taking him off life support after 36 hours. He died a little more than two-and-half-hours later.
The sadness she feels over the loss of her son has been overwhelming, and she has spent years recovering.
"Suddenly I was not a mom - all hope and joy was taken from my life," she said.
She been to counselling but still exhibits "grief bursts." She never knows when they will come.
She spends Mother's Day at his grave, cleaning his stone, having a picnic and remembering his short life.
Experts in mental health conclude that getting help early is vital for helping youth through mental health and addiction issues.
"Early intervention is really important for a lot of different reasons," said Marion Gerull, the clinical director of the Oxford/ ElginChildandYouthCentre. "You can catch something before it gets worse and while family supports are still around to help them."
That said, she noted it is very difficult to force someone who doesn't want to be there into mental health counselling.
"Some young people are able to make informed decisions, to think of future benefits," she said. "It was legally decided at a certain age they are able to accept treatment. That doesn't mean there are capable of making a good decision for themselves."
Pat Baigent, director of community support at the Canadian Mental Health Association Oxford, agreed the earlier the treatment the better but calls the issue "complicated."
"Early treatment is best but it's tough," she said. "The stigma piece is a big factor with young people. No one wants to be different when they are young."
Oxford MP and former Woodstock police chief Dave MacKenzie said he knows Michael's story and spoke to Waugh a few months ago.
"I have all the sympathy in the world," he said. "The lawmakers in the 1980s and 1990s changed everything. Society has changed a lot in 25 years as far as mandated treatments."
MacKenzie, who acknowledged the courts likely won't budge much, said the issue is important and has sent a package of information to the minister of justice.
"I have all the respect for what her issue is and trying to get change," he said. "Change is very difficult. If change comes it will be incremental."